MDMA USE, SOCIAL CONTEXT, AND SEXUAL RISK IN URBAN YOUTH. Jean Schensul1, Sarah Diamond1, Gary Burkholder1, Raul Pino1, 1Institute for Community Research, Hartford, CT United States
Non-injection drug use contributes to HIV risk when drugs are used to enhance sexual pleasure, while reducing protective behavior. MDMA popular among party-going youth, is believed to stimulate sensuality and can lead to more risky sex behavior and HIV exposure. At highest risk are uninformed urban minority youth especially Latino youth, who use MDMA adulterated with unknown substances, increase sex partners, reduce sexual precautions, and market new drugs to peers. This paper links MDMA to sexual risk among urban youth in high HIV-prevalent areas of the U.S. northeast.Participant observation in urban-suburban youth party settings is combined with indepth interviews with MDMA users/distributors, and survey data from two studies of urban mixed ethic youth 16 - 24 on vulnerability to drug use, social networks, drug histories, and sexual risk behaviors. In the first study, participants were 71% male, 29% female, 51% Latino, 38% African American, and 6% Caucasian; mean age was 19. 57% were unemployed, 33% working, and 15% students. 62% had less than a high school graduation. 48% of MDMA users (N=155) compared to 29% of alcohol users (N= 394), 26% of marijuana users (N=397) and 14% of "dust" users (mint with embalming fluid (N=321) reported using drugs for better sex; over half were polydrug users. MDMA users showed higher 30 day use of alcohol (p= .05) and marijuana (p= .03), higher 48 hours use of ecstasy (p=.06), more sex for money/drug exchanges (p= .05) and less condoms use (p=.08). 30 day MDMA users had more sex partners in the past year (P=.06) and past 30 days (P=.001) and were more likely to trade sex for money or drugs (P=.02). There were no differences in number of encounters or frequency of condom use. MDMA converters used condoms less than never-users engaging in oral (p=.06) and anal sex (p=.08). Use occurs in multiple private and public contexts not always associated with clubs, is supported by a variety of media and the wide availability of the drug. A second study of a nonpolydrug using population shows that MDMA is not widely or frequently used and that use is not sustained over time. Urban polydrug using youth are adding MDMA to their drug use repertoires, believing that use enhances sexual performance and engaging in riskier sexual practices after initiation. Harm reduction programs are needed to reduce dangerous interactions and risky sex in unsuspecting urban polydrug users.
USING OBSERVED PARENT-CHILD INTERACTIONS TO UNDERSTAND THE EFFECTS OF PARENT SUBSTANCE USE ON CHILD DEVELOPMENT
Chair: Karl Hill
USING OBSERVED PARENT-CHILD INTERACTIONS TO UNDERSTAND THE EFFECTS OF PARENT SUBSTANCE USE ON CHILD DEVELOPMENT. Karl Hill1, Jennifer Bailey1, Sabrina Oesterle1, 1University of Washington, Seattle, WA United States
Observations of parent-child interactions can provide insights into parenting practices and child behavior not easily admitted to in an interview format (Patterson et al. 1978; Reid et al. 1988; Hops et al. 1995). The present symposium uses observed in-home parent-child interactions to understand how parenting practices are affected by parental substance use, and how they affect, in turn, immediate and broad aspects of development in their children. This symposium presents three studies. The first provides an overview of an observational coding system developed to assess in-home parent-child interactions based on constructs derived from the social development model (Catalano, 1996). Moment-by-moment (micro) and globally (macro) coded constructs for parenting behaviors and child outcomes are examined using two coding systems: one for children 2-8 years old and one for children 9 years and older. Coding is conducted through the use of NOLDUS software. Sample videos as well as reliability and validity data are provided. The second study examines how past and current parental binge drinking and marijuana use affect these observed parenting practices. The third study examines how these observed parenting practices affect immediate, observed child outcomes as well as a broader range of measures of prosocial and problem child development, and how these effects differ for mothers and fathers. In addition to addressing the specific research questions presented, a goal of the symposium is to present the observation of parent-child interactions as a sensitive assessment tool for etiological or intervention studies.
THE SOCIAL DEVELOPMENT MODEL OBSERVATIONAL CODING SYSTEM (SDM-OCS). Amber Tabares1, Karl Hill1, Kevin Haggerty1, Sabrina Oesterle1, Jennifer Bailey1, J. David Hawkins1, 1University of Washington, Seattle, WA United States
This study presents a means to assess social developmental processes comprehensively from age two through adolescence through coded observations of in-home parent-child interactions. The Social Development Model Observational Coding System (SDM-OCS) is a micro- and macro-coded rating system based on the Social Development Model (SDM, Catalano & Hawkins, 1996). The SDM-OCS has been designed to examine constructs described in the SDM, by coding moment-by-moment (micro) and global (macro) patterns of parenting behaviors, child behaviors, and family interaction and affect. The coding system was developed for use in the SSDP Intergenerational Project, a longitudinal study that examines child development and the intergenerational transmission of substance use and risk, and the Family Connections Project, an efficacy evaluation of Parents Who Care, a universal substance abuse prevention intervention for families with adolescent children.
The SDM-OCS examines both verbal and nonverbal behavior during semi-structured, parent-child interaction tasks. Two parallel coding systems were developed: one for children ages 2-8 years old and the other for children 9 years old and above. Psychometric properties of the SDM-OCS are presented based on data from families in Wave 1 (N=200) of the Intergenerational Project and baseline data from the 331 families in Family Connections. Families were videotaped in their homes and observed during three semi-structured tasks. For the young children the tasks consisted of play with provided materials: Child-led Play, Parent-led Play, and Clean-up. For children 9 years and above the tasks consisted of three discussion topics: Beliefs & Expectations About Substance Use; Solving Family Problems; and Recognition.
Inter-rater reliability analyses revealed strong agreement across coders (average kappa of .64 for point-by-point agreement between different coders within a 30-second time interval on micro codes & average percent agreement of 89% across coders for macro-codes). Standardized alpha calculations revealed moderate to high internal consistency for the majority of macro-coded scales (from .68 to .88).The concurrent validity of SDM-OCS scales is supported by statistically significant correlations between scale scores and child, parent and teacher ratings for child problem behavior. Sample parent-child interactions are presented for both younger and older children. Data derived from the SDM-OCS are used in the subsequent two studies in this symposium.
THE EFFECTS OF CURRENT AND PAST SUBSTANCE USE ON OBSERVED PARENTING PRACTICES. Jennifer Bailey1, Karl Hill1, J. David Hawkins1, Sabrina Oesterle1, Robert McMahon1, 1University of Washington, Seattle, WA United States
This study examines the effects of binge drinking and marijuana use at age 27 on observed parenting practices. The effects on observed parenting practices of parents´ past substance use in adolescence also are examined. Data are drawn from The Seattle Social Development Project (SSDP) and the SSDP Intergenerational Project (TIP). SSDP is an 19-year longitudinal study that has followed 808 youth from elementary school (1985) to adulthood with the goal of understanding prosocial and antisocial development across the lifespan. SSDP panel members are now aged 28, and are having and raising children of their own. TIP extends the SSDP panel by examining the effects of past and current parental substance use on development in the subsequent generation. Participants in TIP include those SSDP participants actively parenting a biological child, their oldest child, and an alternate caregiver (typically the spouse).
Previous findings using data from these projects suggest that parent substance use at age 27 is negatively related to some aspects of parent-reported quality of parenting, including monitoring. Using General Linear Modeling, we will extend these findings by asking three main research questions: Are there effects of current parent binge drinking and marijuana use on observed parenting practices at age 27? Do parents´ adolescent binge drinking and marijuana use predict observed parenting practices over and above current use? To what extent are the effects of binge drinking and marijuana use on parenting similar or different?
THE EFFECTS OF OBSERVED PARENTING PRACTICES ON OBSERVED AND REPORTED CHILD PROSOCIAL AND PROBLEM DEVELOPMENT. Karl Hill1, Jennifer Bailey1, J. David Hawkins1, Robert McMahon1, Sabrina Oesterle1, 1University of Washington, Seattle, WA United States
This study examines the effects of observed parenting practices on observed and reported child prosocial and problem development. Data are drawn from the SSDP Intergenerational Project (TIP). SSDP (Seattle Social Development Project) is an 19-year longitudinal study that has followed 808 youth from elementary school (1985) to adulthood with the goal of understanding prosocial and antisocial development across the lifespan. SSDP panel members are now aged 28, and are having and raising children of their own. TIP extends the SSDP panel by examining the effects of past and current parental substance use on development in the subsequent generation. Participants in TIP include those SSDP participants actively parenting a biological child, their oldest child, and an alternate caregiver (typically the spouse).
Observations highlight dimensions of parenting practices that are not easily available via other methods. This study tests whether parent attentiveness, controllingness, provision of opportunities for prosocial interaction and use of rewards and costs for child behavior predict the child's positive interaction and expressions of bonding to the parent during in-home observations. These observed parenting behaviors and child outcomes are then used to predict a broader set of positive and negative child developmental outcomes assessed through parent and teacher interviews. These outcomes include on-time development, parent and teacher reports of cognitive and academic development, social skills, and behavior problems assessed through the CBCL (teacher and parent reports). Using General Linear Modeling, we will examine three main research questions: Do observed parenting practices as suggested by the Social Development Model predict observed positive interaction and bonding in the child? 2) Do these observed parenting practices and observed child behaviors predict a broader range of positive and negative child developmental outcomes? and 3) To what extent do these patterns differ for mothers and fathers?
The majority of prior work on the effects of parenting practices on child development has relied on either parent or child reports; very little work has made use of observational data. From a prevention perspective, observations are tied more closely to the identification of specific behaviors that could be targeted for intervention (Hops et al., 1995). In this study, observed parent behaviors include attentiveness, controllingness, provision of opportunities for prosocial interaction and use of rewards and costs. To the extent that these observed parent behaviors are linked to a broad range of reported child developmental outcomes, they provide identified, empirically supported points for preventive intervention to encourage healthy child development.
EXTENDING DRUG ABUSE PREVENTION PROGRAM EFFECTS TO MENTAL HEALTH OUTCOMES: AN EMPIRICAL EXAMINATION OF THREE PROGRAMS
Chair: Lawrence Scheier
EXTENDING DRUG ABUSE PREVENTION PROGRAM EFFECTS TO MENTAL HEALTH OUTCOMES: AN EMPIRICAL EXAMINATION OF THREE PROGRAMS. Lawrence Scheier1, Paul Brounstein2, 1LARS Research Institute, Las Vegas, NV United States; 2Center for Substance Abuse Prevention, Rockville, MD United States
Evidence is accumulating that a wide range of drug abuse prevention programs incorporating varying prevention modalities effectively reduce early-stage drug use. Methodologically rigorous program evaluations reinforce that drug prevention programs achieve positive outcomes in the manner hypothesized with reductions in drug use resulting from changes in targeted risk mechanisms (i.e., skills and cognitions). As the knowledge base on drug prevention continues to evolve, a separate line of inquiry addresses whether drug abuse prevention programs produce effects on a more diverse set of behaviors not necessarily representing the primary focus of the intervention strategies. For instance, drug prevention strategies could target improved social skills in an effort to offset negative peer influences, and improvement in social skills ameliorates depression. These “unexpected” program effects may foreshadow a broader range of applications for drug prevention programs and encourage wider adoption and dissemination. This symposium dovetails with the explicit theme of the 2005 Society for Prevention Research Annual Conference by focusing on the seamless integration of existing drug prevention modalities with novel extensions to promote well-being. The panel members examine specifically whether three independent prevention programs, guided in part by different prevention modalities, produce effects on specific mental health outcomes (i.e., depression and anxiety). The three evidence-based multi-component programs include a generic life skills approach emphasizing social and personal competence, and two different versions of the Strengthening Families Program applied in diverse settings, emphasizing behavioral parenting skills, children´s life and social skills, and family relationship enhancement. Discussion of each prevention modality considers the respective conceptual frameworks, study design considerations, and statistical findings that support extended program effects to new mental health outcomes. Findings are discussed with regard to basic prevention mechanisms used to uncover the “generative risk mechanisms” linking specific cognitive and behavioral risk factors with mental health endpoints
IMPACT OF LIFE SKILLS TRAINING ON HYPOTHESIZED MEDIATORS: PSYCHOSOCIAL RESILIENCE AND MENTAL HEALTH OUTCOMES. Kenneth Griffin1, Gilbert Botvin1, Lawrence Scheier2, 1Cornell University Medical College, New York, NY United States; 2LARS Research Institute, Las Vegas, NV United States
A common thread that appears across the different prevention literatures is that prevention programs should aim to increase levels of psychosocial resilience in order to protect young people from the precursors and risk factors that generate various problem behaviors. Resilient youth benefit from problem-solving skills, social competence, autonomy, as well as a sense of purpose and future. The Life Skills Training (LST) program is a drug prevention program for middle school students focusing on teaching personal self-management and social skills in order to decrease motivations to use drugs and lessen vulnerability to social influences that support drug use. By teaching skills that help young people negotiate and master developmental tasks, competence enhancement prevention programs such as LST may be protective in that they promote resilience and reduce psychological motivations to engage in drug use and other risk behaviors. The present study examines the effects of the LST program on several variables related to psychosocial resilience that mediate the program´s effects on drug use behavior among middle school students. By increasing our understanding of how competence enhancement prevention programs work, we can improve interventions and better understand how program effects may extend to additional behaviors and outcomes beyond the original scope of the intervention. Findings will be discussed in terms of three important issues: 1) the utility of various drug prevention strategies for influencing psychosocial resilience and mental health outcomes; 2) the benefits of latent growth modeling as a technique to understand change over time among intervention vs. control group participants; and 3) applications of drug prevention programs for preventing other problem behaviors or related risk and protective factors.
UNIVERSAL FAMILY-FOCUSED PREVENTIVE INTERVENTION EFFECTS ON NON-TARGETED ADOLESCENT OUTCOMES: GENERALIZATION OF EFFECTS. Linda Trudeau1, Richard Spoth1, 1Partnerships in Prevention Science Institute, Iowa State University, Ames, IA United States
Background/Objective. Many universal preventive interventions designed to reduce adolescent substance use have shown positive results (Tobler et al., 2000). Studies that have examined the relationship between adolescent substance use and anxiety or depression have found correlations in the range of 17-20% (Armstrong & Costello, 2002), suggesting that positive intervention effects on substance use could generalize to positive effects on anxiety or depression. There have been, however, only very limited studies of the effects of universal prevention programs targeting substance use on associated anxiety and depression outcomes.
The current study extended an earlier examination of the effects of the Iowa Strengthening Families Program (ISFP—Kumpfer, Molgaard, & Spoth, 1996) on symptoms of adolescent internalizing (Trudeau, Azevedo & Spoth, 2004) by evaluating anxiety and depressive symptoms separately, and by examining moderation of program effects by gender.
Methods. Participants were sixth graders enrolled in 22 rural schools. Using a randomized block design, schools were assigned to the ISFP or control conditions; 446 adolescents completed pretesting (238 ISFP and 208 control) 84% (N = 374) completed the posttest, 71% (N = 317) completed the 1½ year follow up, 66% (N = 293) completed the 2½ year follow up, 68% (N = 303) completed the 4 year follow up, and 69% (N = 308) completed the 6 year follow up.
ISFP offers seven sets of weekly sessions; separate, concurrent one-hour training sessions for parents and children, and a joint one-hour family session. Additional detail on ISFP is provided in earlier reports (Spoth et al., 1998, 2001).
Anxiety and depressive symptoms were measured with the Child Behavior Checklist –Youth Self-Report (Achenbach, 1981). Fives waves of data were utilized to estimate growth in anxiety and depressive symptoms. Pretest measures were used as covariates. Intervention and gender were evaluated as predictors of the intercept and slope factors, and multigroup comparison models examined moderation by gender.
Results. Significant intervention effects were found for both anxiety and depressive symptoms. The intervention produced positive results, decreasing the rate of growth for intervention group adolescents compared with controls. Girls, compared with boys, had higher initial levels of both variables, and a significantly higher growth rate for depressive symptoms, but not anxiety. Effects of the intervention were not moderated by gender; both boys and girls showed a comparably positive response to the intervention.
Conclusion. Results supported the positive effects of ISFP on anxiety and depressive symptoms for both genders.
IMPACT OF A UNIVERSAL AND SELECTIVE FAMILY SKILLS TRAINING PROGRAM ON MENTAL HEALTH OUTCOMES. Karol Kumpfer1, 1University of Utah, Salt Lake City, UT United States
Background. Substance abuse prevention programs must modify risk and protective factor mediators in order to increase psychosocial resilience and actually prevent later substance use. Most of the effective substance abuse programs include social and life skills for youth and parents or family members targeting improved communication, problem-solving skills, coping with anger and depression, and stress management that also help improve mental health. The 14-session Strengthening Families Program 6-11 Years (Kumpfer & Whiteside, 2000) is the first drug prevention program designed specifically for a very high-risk group—children of substance abusers. Later clinical trials applied SFP 6-11 to universal populations of elementary school students. SFP includes 14 one-hour sessions of a children´s social skills group conducted while parents attend a parenting group. This is followed by a family skills session for an hour that allows the family to practice and be coached and rewarded for changing behaviors. Methods and Results. This presenter will discuss the original mental health outcomes for the NIDA selective sample in Utah (N=208), which included significant reductions in the children´s externalizing and internalizing behaviors (aggression, depression, psycho-somatization) on the Achenbach CBCL and reductions in parent´s Beck depression scores. These results were also found for the Utah universal sample (N=655 families) using the BASC (Kumpfer, et al., 2002). A longitudinal four-year follow-up shows a dramatic improvement over time in risk or protective factors (school bonding, social competencies, and self-regulation) for SFP compared to a school-based only program. A growth curve modeling analysis of the NIDA Washington D.C. data (N=715) (Wilson, 2004) found similar results, albeit the effect size diminished somewhat for youth conduct disorders when the program was shortened to seven weeks or the sample contained lower risk youth. An “intent-to-treat” analysis also indicated weakened findings because 42% to 29% of enrolled families depending on condition never attended. Conclusions. SFP 6-11 and social skills training programs that teach youth and parents personal self-management and social skills to prevent later substance abuse also reduce youth and parent current mental health problems (i.e., aggression, conduct disorders, depression, and stress) and attenuate later behavioral and emotional problems.